It is known to repair bone fractures using a plate. Typically, a plate is affixed to the side of a fractured bone. It is also known to repair bone fractures using a nail. Currently to fix a fracture of a long bone, such as the femur or tibia, two primary devices exists. To repair a bone fractured at the middle shaft component, or a shaft component within the middle part of the bone, a nail is most commonly used. The nail is inserted into the interior of the bone. The standard for repairing articular fractures, or fractures that go into the joint, or fractures within five centimeters of the joint, on the other hand involves the use and attachment of a plate to the side of the bone.
Unfortunately, both devices suffer drawbacks. Plates attached to the side of a bone, which carry the weight of the patient formerly carried by the now fractured bone, can fail due to moments being placed on the plate by the patient. Specifically, the off-center positioning of the weight bearing plate causes moments to be applied to the screws which attach the plate to the bone. Not only does this place stress upon the fractured area of the bone, but the moment can cause the plate to fatigue. In addition to the foregoing, a doctor must dissect through soft tissue in order to place a plate on the bone. This causes additional trauma to the soft tissue which has already been traumatized by the damage to the bone. If the plate is placed via an open and not percutaneous procedure, the fracture is devitalized and the bone may take longer to heal. In addition to the foregoing, a plate is placed on either the medial or lateral aspect of the bone which may be prominent and painful to the patient.
Nails or rods, which are placed inside the bone to repair a fracture, are typically not inserted along the centerline of the bone. To position the nail in a proper location in the bone, the point of entry of the nail into the bone is typically at the top or top/front of the bone. Thus, for example, when such a device is inserted into the tibia, to insert directly into the centerline of the bone, the position of insertion is at the knee joint. Unfortunately, due to the other structural elements present at the insertion location, current nails are not introduced near the top or end of the bone, but instead near the top along one of the side of the bone. In this location, the nail is not able to extend along the center of the bone over its entire length. Moreover, disadvantages associated with the nail include the inability to fix interarticular fractures, or fractures that extend through the joint and inability to fix fractures within five centimeters of the joint, because of a lack of fixation points. In addition, when a nail is placed into the bone, the rigidity of the nail may cause the doctor to disrupt an interarticular fracture, thus making the fracture of the bone worse.
Current nails may also comprise cumulative tubes which are placed from the traditional starting point of the bone, namely entering from a joint surface. Typically, however, such devices are used for shaft-type tibia fractures, and do not find a use with fractures that are close to the joint, for example within five or six centimeters from the joint.
In addition to the foregoing, a common problem associated with both nails and plates is that they do not include any pivotal components, but are instead a single rigid device. Thus, the devices are extremely limited in where and how they can be used.
Accordingly, what is needed in the art is a percutaneous intramedullary bone repair device that combines the advantages of both the plate and the nail, but is capable of being positioned into the bone along the centerline of the bone so as to effectively reduce the stress of the fractured bone and stress of the device. The device may be attached to the bone to secure the device in place via bone screws or pegs.